LIBERIA 2025!!

Liberia lies in West Africa, just north of the Equator and just east of the Prime Meridian. It is surrounded by Sierra Leone, Guinea, and the Ivory Coast.


 

......We left Grand Rapids on Saturday March 15 and arrived in Monrovia, the capital of Liberia on Sunday evening, a door-to-door journey of about 31 hours. We are serving for a month at ELWA Hospital, an 81 bed facility located about an hour outside of the capital. Things are quite different than when we first served here in 1977!!

The old hospital, started in 1965, was replaced in 2016 by a new building built by Samaritan's Purse. The radio station, which at one time broadcast throughout West Africa, now is more of a local station.

The ELWA base is right along the Atlantic Ocean and occupies a 100 acre compound that includes the Hospital, a Dental Clinic, the Radio Station, and ELWA Academy which includes grades K-12.

Our home for the next month - hot water, good kitchen, reliable electricity, and reliable internet through the cellphone carrier Orange!

 

Here is the view as we leave our front door.

The beautiful Atlantic Ocean!!! We have been to the beach several times - the waves at high tide are incredible!!         

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LIBERIA – a few facts! (thanks to Wikipedia)

**Population: 5.5 million

**Area: 43,000 square miles, slightly less than half the size of Michigan

**Language: officially English but there are about 20 indigenous languages used

**Religion: 85% Christian (various Protestant denominations and Catholic);

                     12% Muslim, 3% other

**GDP: ranks about #179 poorest out of 186 countries

**Brief history:

The American Colonization Society was formed in the US in 1816 to support

repatriation of free people of color and emancipated slaves. Some claimed that this would give them a chance for freedom and prosperity in Africa but some thought that these people might not integrate well into American society and some white Americans believed that African Americans were inferior. In any event, the African American community opposed this project, believing that what appeared to be altruism and philanthropy was actually racism.

 Between 1822 and 1861, about 15,000 freed and free-born African Americans and 3000 Afro-Caribbean people were located to Liberia. Many succumbed to tropical diseases.

 Liberia declared independence in 1847 but was not recognized by the United States until 1862; it is the oldest modern republic in Africa.

 Americo-Liberians did not integrate well with the indigenous tribes and formed a small political elite that was in control for many years. This dominance was broken in 1980 when a violent military coup ended Americo-Liberian rule and a dictator from an indigenous tribe took over. In 1990, this dictator was assassinated in the midst of a civil war which lasted until 1997 when a rebel leader was elected. A second civil war erupted in 1998 and lasted until 2003 when the rebel leader was overthrown and went into exile.

 During these coups and civil wars, about 250,000 Liberians were killed, many were displaced from their homes, and the Liberian economy tanked by 90%

 Democratic elections were finally held in 2005 and there has been political stability since.

The country was rocked again from 2014-2016 when Liberia was the epicenter of the Ebola outbreak. The 3 Americans med-evacuated to the US urgently all served at ELWA Hospital.

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Water!!!!! (Togo 2024)

 Most of us don't give a second thought to our water supply - when we turn on the faucet, we know that clean water will come out. How often we leave the water running while brushing our teeth or take long showers or fill the tub for a bath!  Such luxury!!!!

In many parts of Africa, water is neither plentiful nor clean. Waterborne illnesses like typhoid, parasites, and worms are the result, causing much disease and even death.

Mango, the town where the Hospital of Hope is located, is fortunate to have a "city water" supply. This comes from a nearby river and is filtered by the city. When it reaches HOH, it is refiltered for maximum safety. Unfortunately, the city supply can be inadequate at times. Missionaries who live off of the compound have been without water for the past three weeks. Multiple past efforts to dig an adequate well on the base have been unsuccessful. Recently, the hospital has had to go to "plan B" which involves hauling water from the nearby river in large cisterns 5 times a day, filtering it, and pumping it up to the water tower which is on the base. Then, the water reaches our taps by gravity.

This truck and 2500 gallon tank make 5 trips daily to a nearby
river to get water. Each trip takes a little over an hour!

Water from the tanks is filtered, transferred to a
holding tank, and then pumped up into the water 
tower. Amazingly, gravity passively delivers it to 
our water taps!

....at the Station

 The Station is the central area of the hospital where nurses, doctors, and PAs gather. Some are focused on the urgent care/ER department which is called "Rea" (for reanimation) while others are focused on the inpatients. There is often collaboration between these two areas. The Hospital of Hope is blessed to have many Togolese nurses who have trained at the onsite nursing school as well as some expat nurses - their level of care is excellent!!

This is the "Rea" unit which functions as an urgent care/ER
 area. Some of the team for the day is in the picture below.

At the right is Kayli, a senior med student from Texas. Next to her is Alain
who has been at HOH from its opening - he started as the hospital
administrator but later went back to Physician Assistant school so
that he could help in patient care! At the left is Mike, a nurse who has
also served here from the beginning. In back is Dr. Arung, a 
surgical resident from Cameroon who recently started his 
5 year training program.

Across the nursing station from Rea is where the 
inpatient docs work. Susie is entering progress notes
onto the computer and conferring with nurse Alassi!

We have enjoyed getting to know Kayli, who will
soon return to Texas for med school graduation.
She is going into Family Medicine and hopes to
pursue medical missions! 

Au Clinique....at the clinic!!

 Clinic is held every day except Sunday. The hours are 730 AM until 5 PM except that Weds and Sat are half days.

The hope is that all patients will be seen that day but, if the number of patients is high and the number of providers is low, less ill patients may be asked to return the next day. 

Each morning, patients line up and are briefly evaluated by the "triage docs" at 730 AM who decide whether a patient is urgent, semi urgent, or has more of a chronic or non -life threatening problem. Sick children are given priority. Patients then register and are given a carnet, which is a small booklet in which brief notes and prescriptions are written.

Throughout the day, more patients arrive and the provider who is the "point person" of that day does more triage every few hours. 

Dave was in the clinic the first week and saw 20-25 patients daily. We are fortunate to have excellent translators who speak excellent English, the "official" language of French, and several tribal languages. 

The range of illness is broad - musculoskeletal aches and pains and gastritis are common but malaria, pneumonia, TB, typhoid, intestinal parasites, cancers, and sickle cell disease are also seen.

A typical exam room with computer terminal for ordering labs and 
xrays. Results are usually available later in the day.
Digital xrays are great!

People waiting for the triage process to begin at 730 AM.
Many arrived the previous day.

Patients who have been registered waiting their
turn outside the exam rooms.

This is another group of people who have arrived later in the
day and are awaiting the ongoing triage process. Sick children
and ill-appearing adults are given priority.

On the Road to Togo....

 We left Grand Rapids early Monday morning January 8 and arrived in Lome, the capital city of Togo, 24 hours later at Tuesday noon. After a night at a modest hotel, our hospital driver met us at 7 AM for the long drive up to the Hospital of Hope. The roads were quite good by African standards and we made the 330 mile drive in just under 9 hours. 

       

           

Togo is a narrow strip of land just to the east of Ghana. It lies near the Prime Meridian and we are about 8 degrees north of the Equator.              

Our long drive started in Lome and we made our way north through Atakpame, Sokode, and Kara.  The Hospital of Hope is located in Mango, which is about 40 miles south of Dapaong.

Many vehicles are crammed full of people with all sorts of belongings tied to the roofs. We also shared the road with many motorcycles and assorted farm animals.

Drivers use their horns frequently to announce their presence and intentions of passing. After passing another vehicle, they pull back into their lane very quickly - thankfully, we did not witness any "road rage"!!

Safe arrival!!!!!

We are staying at the Guesthouse which has about 8 separate rooms which are quite comfortable. There is also a large common area where meals are prepared and served by Togolese staff. The common area is also where meetings and Sunday evening church services are held.

We are blessed beyond measure....Happy New Year 2024!! .....on to Togo!!!

                  God has blessed us with two fine sons (Ted and Toph), two wonderful 

                          daughters-in-law (Jodi and Gabe), and 6 incredible grandkids:

            Stella(14 1/2), Dexter(13), Lincoln(11), Edison(9 1/2), Anders(3 1/2), and Uriah(2).

........on January 8, we are headed to Togo to serve at the Hospital of Hope. We were there in the Spring of 2022 - scroll back to see blogposts from that trip.

Time with new friends!

          

Dr. Tadeo is a 4th year Family Medicine resident in the Kabarak University program. We greatly enjoyed getting to know and work with him! He is from Uganda and has an amazing story- he is the only one in his family to have much education and, at various times, has helped support himself by working

as a cobbler and as a high school math teacher! We had a nice birthday 

celebration for him a couple nights ago

with Dr. Lisa. Susie made "mung stew", a tasty concoction of mung beans (also known as "green grams") and vegetables served over rice.

 

We also enjoyed getting to know Dr. Gerhard and Janie Schumacher. Gerhard is the Medical Director and Janie teaches anatomy at the nursing school as well as arranges/coordinates the comings and goings of long-term and short-term visitors.  Yesterday, they drove us an hour to the city of Iten, where we walked through a huge open air market - there was a wide assortment of shoes, clothes, cellphones, knick-knacks, fruit and vegetables for sale!!                                                                                                                

                                                                                                                                                                    

One vendor had a nice assortment of soccer jerseys that caught Dave's attention!                                                                                                                                           

After the market, we went to the Kerio View Hotel and Lodge. The Kerio Valley parallels the Rift Valley and is amazing in its expanse and beauty. This is the view we enjoyed as we had lunch on the patio! ....Iten is a training center for Kenyan runners but, unfortunately, we did not catch a glimpse of any of them!!

                                                 What an incredible view!!!!